Centro de Pesquisa Clínica e Epidemiológica do Hospital Universitário da Universidade de São Paulo, Avenida Prof. Lineu Prestes, 2565, Cidade Universitária, São Paulo, Brazil; Faculdade de Medicina da Universidade de São Paulo, Avenida Doutor Arnaldo, 455, Cerqueira César, São Paulo, Brazil.
Centro de Pesquisa Clínica e Epidemiológica do Hospital Universitário da Universidade de São Paulo, Avenida Prof. Lineu Prestes, 2565, Cidade Universitária, São Paulo, Brazil.
Atherosclerosis. 2015 Jun;240(2):529-34. doi: 10.1016/j.atherosclerosis.2015.04.800. Epub 2015 Apr 25.
Studies focusing on the association between anxiety/depressive symptoms and accelerated subclinical atherosclerosis have yielded mixed results. Our aim is to examine associations between anxiety/depressive symptoms, common mental disorder (CMD), major depression disorder (MDD) or generalized anxiety disorder (GAD) and carotid intima-media thickness (CIMT) in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort baseline.
The ELSA-Brasil baseline assessment included CIMT measurements and the Clinical Interview Schedule - Revised (CIS-R), a validated questionnaire for anxiety/depressive symptoms/diagnoses. We analyzed participants without previous coronary heart disease or stroke, and with high-quality CIMT images. We built regression models to determine whether the CIS-R score, CMD, MDD or GAD were associated with maximal CIMT levels.
The study sample comprised 9744 participants. We found that individuals with higher CIS-R scores (Odds ratio for one standard deviation increase [OR]:1.12; 95% confidence interval [95%CI]:1.06-1.19), CMD (OR:1.22; 95%CI:1.07-1.38) and GAD (OR:1.19; 95%CI:1.01-1.41) had significantly higher odds of being classified in the highest age, sex and race-specific CIMT quartile. In the linear models, after adjustment for traditional cardiovascular risk factors, higher CIS-R scores (β:0.005; P = 0.010) and GAD (β:0.010; P = 0.049) were independently associated with CIMT values.
Individuals with more symptoms of anxiety and/or depression, or diagnoses of CMD or GAD, had higher CIMT values, compared to peers of same age, sex and race. CIS-R scores and GAD were independently associated with higher CIMT values. These results suggest an association between anxiety/depressive symptoms (and, most notably, GAD) and accelerated subclinical atherosclerosis.
关注焦虑/抑郁症状与亚临床动脉粥样硬化加速之间关系的研究结果不一。我们的目的是在巴西纵向成人健康研究（ELSA-Brasil）队列基线中，检查焦虑/抑郁症状、常见精神障碍（CMD）、重度抑郁症（MDD）或广泛性焦虑症（GAD）与颈动脉内膜中层厚度（CIMT）之间的关联。
ELSA-Brasil 基线评估包括 CIMT 测量和临床访谈表修订版（CIS-R），这是一种用于焦虑/抑郁症状/诊断的有效问卷。我们分析了没有先前冠心病或中风且 CIMT 图像质量高的参与者。我们构建了回归模型，以确定 CIS-R 评分、CMD、MDD 或 GAD 是否与最大 CIMT 水平相关。
研究样本包括 9744 名参与者。我们发现，CIS-R 评分较高的个体（每标准偏差增加的优势比[OR]：1.12；95%置信区间[95%CI]：1.06-1.19）、CMD（OR：1.22；95%CI：1.07-1.38）和 GAD（OR：1.19；95%CI：1.01-1.41）的个体被分类为最高年龄、性别和种族特异性 CIMT 四分位数的可能性显著更高。在线性模型中，在校正传统心血管危险因素后，CIS-R 评分较高（β：0.005；P=0.010）和 GAD（β：0.010；P=0.049）与 CIMT 值独立相关。
与同年龄、性别和种族的同龄人相比，焦虑和/或抑郁症状更多、CMD 或 GAD 诊断的个体 CIMT 值更高。CIS-R 评分和 GAD 与更高的 CIMT 值独立相关。这些结果表明，焦虑/抑郁症状（尤其是 GAD）与亚临床动脉粥样硬化加速之间存在关联。
